to this affection. It is generally due to disease of the
inter-vertebral cartilages and bodies of the vertebrae. It comes on in a
slow, insidious manner, hence, it often makes serious inroads upon the
spine and system before its character is even suspected.

[Illustration: Fig. 1.

The above portion of the spinal column shows the manner of the breaking
down of the vertebrae from caries,
and the absorption of their bony
structure.]

Generally the first point of invasion is the cartilaginous substances
between the bodies of the vertebrae, beginning with inflammation, and
finally resulting in ulceration and a breaking-down of the cartilages.
It next invades the vertebrae themselves, and producing caries, or death
and decay of the bony substance, which softens and wastes away, as shown
in Fig. 1. The vertebrae become softened and broken down, and weight of
the body pressing them together produces the deformity known as
"humpback." (See Fig. 2 and Fig. 3.)

SYMPTOMS. Among the various symptoms present in the earlier stages of
the disease, and during its progress, we deem it necessary to mention
only a few of the more prominent ones. While the patient is yet able to
go around, the disease manifests itself by occasional pain in the
bowels, stomach, and chest. Often there is a hacking cough, nervousness,
lassitude, and a generally enfeebled condition of the whole system. The
patient is easily fatigued; there is apparent loss of vitality, impaired
appetite, a feeling of tightness across the stomach and chest, gradually
declining health, and loss of flesh and strength, torpidity of the
liver, deficient secretions, constipation, and morbid excretions from
the kidneys. The victim, in passing chairs, tables, and other objects,
instinctively places his hands upon them, and, as the disease
progresses, when standing, leans upon some support whenever possible. In
walking, he moves very carefully and cautiously, with elbows thrown back
and chest forward, to assist the body in keeping its equilibrium. The
body being kept in an upright position, the patient bends the knees
rather than the back in stooping, as illustrated in Fig. 5, and the body
is frequently supported by the hands being placed upon the thighs or
knees. Sudden movements or shocks cause more or less pain.

The development of the disease then becomes rapid; suffering increases,
and pain about the joints and lower extremities and muscles of the
posterior part of the pel